Nitric oxide is responsible for activating new precursor cells for skeletal muscle growth and muscle repair from injury or disease. Sufficient blood flow to muscles and other organs that are recruited during any types of physical exercise is often necessary to meet an increased demand in nutrients by these muscles and organs. The endothelium of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, thus resulting in vasodilation and increasing blood flow. NO production is important for increasing vasodilation to meet the increased demand in nutrients by muscles and organs during physical exercise. Also, NO is an important signaling molecule that is widely used in the nervous system, affecting, for example, synaptic plasticity (long-term potentiation, LTP; long-term depression, LTD). Due to the roles that nitric oxide plays in muscle growth and repair, as well as its involvement in neural signaling, it is a factor to be considered in various muscular, neural, and neuromuscular diseases.
Additionally, therapeutic peptides represent a promising class of drugs in the treatment of neuromuscular and neurological diseases or disorders. In general, the development of peptide therapeutics has been limited by challenges including poor in vivo stability, poor solubility, incompatibility with oral administration, shelf stability, and cost of manufacture.